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What Is Lean? (Purple Drank)

  1. Table of ContentsPrint
  2. What Are its Side Effects?
  3. Can I Become Addicted to Lean?
  4. Treating An Addiction

purple cough syrup being poured onto spoon

Many new drugs and drug concoctions have made their way onto the market and into homes in recent years. Some of these drugs are simple homemade creations, but they can be extremely potent and dangerous.

Since adolescents can make the drink out of easy-to-obtain ingredients, they often get together with friends to add their favorite sodas and candies to the cough syrup without understanding that purple lean is a powerful narcotic drug that can have serious and dangerous health effects.

Lean—also known as purple drank, purple lean, sizzurp, dirty sprite, and lean drink—is a combination of the following:

  • Prescription-strength cough medicine.
  • Soft drinks.
  • Hard, fruit-flavored candy.

The prescription cough syrups used to make lean drink present the most danger because they often contain codeine, a powerful opioid drug 1. Another active ingredient in some prescription cough syrups is promethazine, an antihistamine that causes sedative effects and can impair motor functioning 2.

The drug codeine is what is known as an opiate drug or opioid drug, and is frequently used as a cough suppressant or mild analgesic 3. When codeine is consumed in large doses or for non-prescription purposes, however, it can create extremely harmful effects. Because the drug is created as a liquid to drink (hence its alternate names purple drank and dirty sprite), users can easily lose track of how much of the active drug they have consumed since the cough syrup is masked by pleasant or familiar flavors from soda and candy. And this is where the potential danger lies.

Few statistics are available on its use and abuse since it is a relatively new drug. Also, the ingredients in purple lean are legal, so it is difficult to track its use and abuse. Making the trend of abusing lean drink even more complicated are the many celebrities and professional athletes who have been at the center of news stories about the drug, including Lil Wayne 1, Justin Bieber 1, and Rob Kardashian 4. Their media coverage has made sizzurp a hot topic with the tweens and teens who look up to them and now think that it is safe or cool to use 1.

If you are concerned that your teen might be using drugs, look for the common warning signs.

What Are its Side Effects?

Lean drink side effects may gradually worsen as a person drinks more of the concoction. However, first-time users may also notice unpleasant side effects such as 1:

  • Dizziness.
  • Blurred vision.
  • Nausea.
  • Memory problems.

Regular purple drank use can cause additional, widespread health issues. Individuals who use the drug regularly report suffering from 2:

  • Dental decay.
  • Constipation.
  • Weight gain.
  • Urinary tract infections.

People who abuse purple drank in the long term or in sufficiently large doses may suffer from life-threatening effects, which may be exacerbated when it is used in combination with other drugs. Some cases of coma and death have been reported and attributed to purple drank use. The risk of death is highest when combined with other sedative drugs or depressant substances such as alcohol 2.

Many people believe the drug is safe because it contains substances regularly prescribed by doctors (cough syrup, antihistamines), but it can and does cause disastrous health problems and even death. In fact, even those celebrities who are credited for making purple lean famous are now having serious health problems. In 2012, Lil Wayne began having seizures after a long history of abusing lean,1 and in 2000 DJ Screw died of a codeine overdose 4.

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Can I Become Addicted to Lean?

teen boy sitting on steps thinking about lean addiction

Codeine, the primary ingredient in purple lean behind its desirable yet harmful effects, is an opioid—a class of drugs associated with an extremely high rate of addiction. The highly addictive nature of opioids is due, in part, to their rewarding, pleasant effects such as euphoria, relief from tension and anxiety, and decreased aggression 3. However, opioids should only be used in a therapeutic context under the direction of a physician and should only be taken as prescribed.

Because prescription codeine is a legal substance that many people use to legitimately manage pain- or cough-related medical issues, it is difficult to track rates of abuse and addiction. According to the 2011 Monitoring the Future Report published by the Drug Enforcement Agency, 2.9% of 8th graders, 4.3% of 10th graders, and 5.0% of 12th graders abused cough and cold medicines in the previous year for recreational purposes 5.

Chronic use of opioids, such as the codeine found in purple drank, can lead to the development of drug tolerance or dependence. As tolerance mounts, people may find themselves needing to consume increasing amounts of the drug to experience the desired effects. This ramping up of drug taking behavior can drive the development of significant physiological dependence. Opioid-dependent people are likely to experience a range of unpleasant withdrawal symptoms should they go without the substance for too long. In the beginning stages of withdrawal from an addictive drug, an addicted person may experience 6:

  • Difficulty sleeping.
  • Agitation.
  • Muscle aches.
  • Increased tearing from the eyes and a runny nose.
  • Anxiety.
  • Sweating.
  • Increased yawning.

If a person has used purple drank for a long time or in high doses, they may suffer more intense withdrawal effects, including 6:

  • Diarrhea.
  • Nausea.
  • Vomiting.
  • Abdominal cramping.
  • Goose bumps.
  • Dilated pupils.

To avoid or end withdrawal symptoms, people addicted to the drug will often return to using purple drank or other opioid drug, thus creating an endless cycle of abuse that can destroy their health.

Treating An Addiction

In an inpatient setting, withdrawal and addiction programs may offer patients medications to help them get through the symptoms as comfortably as possible.

Many people are surprised to learn what drinking lean can do to their bodies, yet, even after learning about the harmful side effects, they continue to use. Seeing their favorite celebrities using the concoction and boasting about their experiences with the drug often encourages the behavior. When continued use of purple lean leads to addiction, professional addiction treatment becomes necessary.

Because the withdrawal symptoms caused by codeine addiction are so uncomfortable, many people choose to go through withdrawal in an inpatient detox setting and then transfer to an addiction treatment program 6. In an inpatient setting, withdrawal and addiction programs may offer patients medications to help them get through the symptoms as comfortably as possible. Though codeine is a relatively low-potency opioid drug, should the acute opioid withdrawal syndrome be significantly severe, medications such as methadone, buprenorphine, clonidine, and naltrexone may be administered to manage symptoms 6.

If you are ready to get treatment for lean addiction, consider these options:

  • Detoxification: A formal detox program or medical detox program is short-term inpatient treatment that helps you get through the first few hours or days following drug use as comfortably and safely as possible. Many people choose to transition from a detox program to an inpatient addiction treatment program to begin their recovery.
  • Inpatient-style treatment: Inpatient programs require you to live at a treatment facility where you receive around-the-clock care. Inpatient programs are best for people whose addiction is more severe and need constant supervision for their own wellbeing and to improve their chances for obtaining recovery.
  • Outpatient-style treatment: During outpatient treatment, you live at home and attend treatment during business hours for anywhere from 2 to 8 hours a day for 2 to 5 days a week.
  • 12-step groups: 12-step groups such as Narcotics Anonymous help you progress through the steps of recovery by incorporating member stories, helpful literature, and a sponsor support system.
  • Support groups: Similar to 12-step groups, but often with a more secular-based recovery philosophy, other support groups can help you overcome your addiction to lean in a self-paced, group environment.

Whether it’s called lean, purple drank, sizzurp, or any other name, this concoction is a drug that can be lethal in high doses or when mixed with other sedative drugs or alcohol. Repeated use can cause serious health problems and even death.

Calling for Help for Your Teen?

Making the decision to ask for your help for you child can be a stressful one, but it can be made less so by understanding what will happen during the call. Likely, you'll be asked for the following types of information:

  • When your child began abusing substances
  • How long the substance abuse has been going on
  • The dose/average amount they are consuming
  • Any major changes you've seen in your child (e.g., Have they become violent, had thoughts of self-harm, become depressed?)
  • Whether your child has any diagnosed mental health disorders
  • Whether they are currently taking any medications
  • If they have any physical disabilities or limitations
  • Whether they have been in treatment for substance abuse before now
  • Whether anyone else in the household abuses substances
  • Whether you have current insurance for your child. (Have your insurance card on hand to provide details you can give the admissions consultant so they can help to determine your coverage).


  1. National Institute on Drug Abuse for Teens. (2013). Sizzurp: It’s not cool.
  2. U.S. Department of Justice. (2011). Drug alert watch: Resurgence in abuse of ‘purple drank.’
  3. Drug Enforcement Agency. (n.d.). Drug fact sheet: Narcotics.
  4. Stephenson, A. (2014). Sizzurp: What is it and why are so many celebrities getting hooked on it?
  5. Drug Enforcement Agency. (2014). Dextromethorphan.
  6. U.S. National Library of Medicine. (2016). Opiate and opioid withdrawal.
Last updated on November 25, 2018
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